Greenwich, CT - Between birthday parties and school cafeterias, childhood can be difficult for youngsters who have celiac disease, a digestive condition that interferes with absorption of nutrients from food.

The only treatment for celiac disease is a gluten-free diet, and it's not easy. Gluten is a proteinfound in wheat and other grains. So forget about regular cereal, sandwiches, cookies, pasta, and so many of a child's favorite foods. Gluten is also present in many added food stabilizers and preservatives and, through cross-contamination, may wind up in vitamins, medicines and other products.

"One problem with celiac disease in children is that it often goes undiagnosed," said Anthony Porto, MD, a pediatric gastroenterologist at Greenwich Hospital in Connecticut. Some children experience constipation or belly pain as a symptom, and it's dismissed as a common childhood virus. Infants and young children with celiac disease may experience abdominal bloating, chronic diarrhea, vomiting and weight loss. Symptoms vary from child to child and may also include irritability and behavioral issues.

"Proper diagnosis is critical for children because malabsorption of nutrients in a child's formative years can manifest itself in delayed growth, delayed puberty, damage to dental enamel and other problems that may last a lifetime," explained Porto.

Dr. Porto tests for celiac disease in a couple of ways. One is through blood tests, and another through a procedure called an upper endoscopy that allows him to take a small sample from the small intestine. The sample is reviewed by a pathologist under a microscope, as eating even a small amount of gluten can damage the small intestine. This endoscopy is used to confirm results that the blood tests suggest.

Once a diagnosis is made, dietitians at Greenwich Hospital help parents learn how to make informed decisions at the supermarket and when eating out.

"The sooner a child is diagnosed, the better he or she can learn to enjoy allowable foods that include corn (and corn tortillas), nuts, potatoes, rice, and legumes like peas and beans. Ultimately, we want to help these kids prevent long-term complications with bone growth and fertility. The teenage years are stressful enough without having to worry about this," said Porto.

When families understand the sources of gluten and how it affects the body of someone with celiac disease, they can help a child become socially ready for parties and school meals with a variety of foods they can get used to and enjoy throughout life.